The Institute for Clinical and Translational Science (ICTS) at the University of Iowa (UI) was established by the Board of Regents to realize three objectives - first, to lead the development of translational science at the UI; second, to advance translational science as a distinct academic discipline; and third, to disseminate capacities in translational science across the State of Iowa. This mandate enabled us to tackle large problems affecting translational science that required institutional solutions, such as transforming regulatory processes for human subjects research, developing an informatics infrastructure for integrating electronic medical record and other health care data, establishing bi-directional relationships with community organizations, and revitalizing the pipeline of well-trained clinical and translational researchers. The task for this new application is extend our impact and to build a model learning health system (LHS) to integrate research and practice across the lifespan and across the T0 - T4 translational spectrum with the intent of accelerating the translation of discovery to improved population health. Becoming an exemplary next generation CTSA that can produce logarithmic acceleration requires refocusing many current programs and creating new resources to: (1) promote workforce development; (2) systematically engage stakeholders; (3) integrate translational research along several distinct dimensions; and (4) spur innovation. The milestones for this application have a special focus on rural health, community engagement, research- practice integration, clinical research efficiency, innovative statistical methods, and rare genetic diseases. In addition, some of the milestones reflect our interest in working with other CTSA hubs to empirically test different approaches and for developing an evidence base of proven strategies for accelerating translation that can be more broadly disseminated. In this way we can incentivize the development and adoption of new methods and promote innovation in everyday research processes throughout Iowa and beyond our borders. In particular, we will engage investigators and stakeholders across Iowa using approaches that overcome the geographic barriers in a rural state and that build on our established community practice networks of family physicians, clinics, school nurses and pharmacists, with particular examples related to lifespan research and child abuse. To build this LHS we will engage and train undergraduates, pre and postdoctoral trainees, established investigators research staff and clinicians at the UI and in the newly formed UI Health Alliance (an integrated network of 58 hospitals, 175 clinics, critical access hospitals in rural communities regional medical centers, and the UI) which touches 60% of the population in Iowa to drive clinical and translational discovery and to change healthcare practice in a variety of clinical settings.